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MEMORIAL RESOLUTION DAVID A. RYTAND
(1908-1991)
SenD#4012 StCD#6165
David A. Rytand, Arthur L. Bloomfield Professor of Medicine Emeritus,
died on November 23, 1991 after a long illness. He had been at Stanford for 65
years and was one of the medical schools most distinguished scholars, clinicians,
and teachers.
David Rytand was born in San Francisco and attended the public schools
there. He entered Stanford as a freshman in 1926 and continued on to the
medical school, receiving his M.D. in 1932. He then began a 59 year career in the
Department of Medicine, as an intern and resident initially, and then as a full
tme faculty member. In 1984 he recalled these early days in a delightful
monograph, Medicine and the Stanford University School of Medicine circa 1932: The Way It Was.
In the 1930s and 1940s he achieved high distinction as a critical and
original scholar in medicine as well as prominence as a clinical consultant and
teacher. He had wide interests, including the physiology of the kidney and many
areas of internal medicine. A study published in 1937 on the number and size of
the glomeruli of the kidney in mammals of widely varying body size quickly
became a classic, and was still being cited regularly more than 50 years later.
After World War II he increasingly focussed his work in the field of heart
disease. However, he resisted the exclusive specialization on heart disease that
developed rapidly at this time, and retained his interest and professional identity
in the broad field of internal medicine.
Upon the retirement of Dr. Bloomfield in 1954 Dr. Rytand became the
Chairman of the Department of Medicine, and in 1958 he became the first Arthur
L. Bloomfield Professor of Medicine. This was the first endowed chair in the
School of Medicine. He served as Chairman through the transitional period in
Memorial Resolution, David A. Rytand--continued ...
the late 1950s in which the medical school remodelled its faculty and curriculum,
established a new emphasis on basic research, and moved from San Francisco to
the new Medical Center on the university campus. He stepped aside as
Chairman in 1960 and returned to his first love as a clinician, clinical teacher and scholar.
He became a uniquely popular clinical teacher among the new generation
of medical students and residents. He also returned to research, primarily on his
long-time hobby of atrial flutter, an especially intriguing type of irregularity of
the heart beat, since it appeared likely to have a specifically identifiable
mechanism, if only someone could elucidate it. He acquired new data, using the
opportunities now available from the development of surgery on the heart, and
convincingly established the long-controversial theory of circus movement
around the entire right atrium as the mechanism.
The circus movement mechanism implies that the electrical activation of
the atrium is continuous and exactly repetitive, and hence that the recording of it
in the human electrocardiogram should be perfectly regular, constant in
waveform, and continuously undulating. Dr. Rytand delighted in promoting
simple optical methods to demonstrate these features, using a cylindrical lens, or
even more simply viewing the electrocardiographic recording at an angle to
foreshorten the waveform. Because of the large variety of atrial arrhythmias that
appear in electrocardiograms, these features are still not widely emphasized
sufficiently, although their validity has been amply proven.
Upon becoming Emeritus in 1975, Dr. Rytand moved to the Santa Clara
Valley Medical Center in San Jose, a major affiliated hospital where much of the
clinical teaching of Stanford medical students takes place. There he established a
new legacy of excellence in clinical teaching. He returned to the Stanford
Medical Center in 1980, where he served as Director of Medical Alumni
Relations. He also continued to teach medical students; until shortly before his
death he met regularly with students to discuss electrocardiograms.
David Rytand was a member of the American Association of Physicians,
the American Society of Clinical Investigation, the Western Society of Clinical
Investigation (President in 1954), the Western Association of Physicians
(President in 1959), and the California Academy of Medicine (President in 1985).
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Memorial Resolution, David A. Rytand-continued ...
In 1984 he received the Albion Walter Hewlett Award of the Department of
Medicine, one of the most prestigious awards in the School of Medicine. On this
occasion Professor Alan Barbour wrote that David had achieved immortality by
accomplishing several notable goals. "First, you must discover a basic law of
nature. Rytands Law, as it is now known, was discovered in 1951: 'The
prognosis for a patient with myocardial infarction is worse when anticoagulants
are given to someone else' .. . Now, the second rule of immortality: you must
have a disease named after you. Dave described nine patients with a unique late
diastolic murmur associated with calcification of the mitral annulus and A-V
block in 1946 ... This is known variously, but we prefer 'la maladie de Rytand' as it
is described in the French literature ... Of all this, when asked in a recent
interview to describe what he took to be his greatest achievements, Dave
anwered simply, 'Two things. I taught students. And I listened to patients."'
David leaves his widow, Nancy, a daughter Sally Plaisted of Menlo Park,
two sons, David H. Rytand of Anacortes, Washington and William Rytand of
Palo Alto, and six grandchildren.
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E. William Hancock, Chair William P. Creger Roy Cohn Marcus Krupp